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Yewtree Care Limited t/a Yewtree Nursing Home Requires improvement

We are carrying out a review of quality at Yewtree Care Limited t/a Yewtree Nursing Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 11 March 2020

About the service

Yewtree Nursing Home is a residential care home providing personal and nursing care for up to 36 people with various support needs, including brain injury, learning disability, physical and/or sensory impairment. At the time of our inspection, 36 people were in residence. The home is set in easily accessible grounds and consists of one adapted building. There were a range of communal areas for people to enjoy.

People’s experience of using this service and what we found

Feedback from people was largely positive. One person told us, “I'm very happy here”. Another said, “You couldn't better the staff”. We found, however, that people who were cared for in their rooms lacked social contact. Although they had contact and conversation with staff when care was being provided, there was little time for social contact or activity. Following our feedback, the provider took action to increase the staff time dedicated to providing one to one activity and we will assess the impact of this on our next visit.

Action was needed to improve the systems and processes in place to monitor and improve the service. We found audits had not always been effective at identifying issues, ensuring problems were resolved or sustaining improvements.

While staff knew people well and understood how they wished to be supported, care records did not always contain complete or up to date information to reflect the person’s current needs.

The registered manager had only recently started to carry out best interest decisions when a person lacked capacity to make their own choice. We identified a missing capacity assessment and best interest decision for one person where bed rails were in use. Further time is needed to embed changes in the approach to, and recording of, decisions under the Mental Capacity Act (MCA) to ensure people’s rights are respected.

People had given their consent to the use of CCTV in communal areas. We have made a recommendation about making signage more apparent to alert visitors to its use.

People were looked after by kind and caring staff who knew them well. People with capacity were encouraged to be involved in decisions relating to their care and were treated with dignity and respect.

People's communication needs were identified and planned for, but the registered manager was not aware of the Accessible Information Standard (AIS). We have made a recommendation about this in the report.

People expressed confidence they could raise any issues or concerns with any member of staff or the management team and these would be addressed.

People could spend the rest of their lives at the home, if their needs could be met and this was their wish. Staff worked proactively with healthcare professionals to facilitate this.

People spoke positively about the staff who supported them and had confidence in their skills and experience. Staff had regular supervisions and an annual appraisal. People enjoyed the food and were able to make suggestions for changes to the menu. Snacks and drinks were readily available throughout the day.

Care staff were well informed about risks to people's health or wellbeing and knew how to deliver their care safely. Staffing levels were enough to meet people's needs. Medicines were managed safely. The home was clean, and staff had been trained in infection prevention and control. Lessons were learned if things went wrong.

People had access to a range of healthcare professionals and support. Premises were suitable and comfortable and met people's needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 12 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and

Inspection areas

Safe

Good

Updated 11 March 2020

The service was safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 11 March 2020

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 11 March 2020

The service was caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 11 March 2020

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 11 March 2020

The service was not always well-led.

Details are in our well-Led findings below.